In this study we wish to investigate the analgesic effect of the administration of 0.2% ropivacaine for an adductor canal block as repeated boluses (20 ml every 8 hours) through a new suture-method catheter or a standard perineural catheter compared with a single bolus (20 ml), in patients following primary total knee arthroplasty.
The aim of the study is to compare the clinical effects of three different administration forms for an ACB: repeated intermittent boluses through a Certa catheter (CC) versus repeated boluses through a standard catheter (through the needle) (SC) versus a single bolus (SB). Our dual hypothesis is that repeated boluses through a catheter (either Certa or standard catheter) reduces opioid consumption (primary outcome), as well as reduces pain scores, enhances ambulation and muscle strength compared with a single bolus, and that the Certa catheter is superior to a standard catheter.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
153
10 ml of ropivacaine 0,75% will be used to ensure correct position of the needle and to expand the adductor canal, followed by injection of another 10 ml of ropivacaine 0.75% via the catheter during real time US imaging to ensure correct placement of the catheter.
20 ml of ropivacaine 0.75%
20 ml of ropivacaine 0.2% every 8 hour in the catheter
Gentofte Hospital
Copenhagen, Denmark
Total opioid consumption
• Total opioid consumption (PCA pump and any potential rescue administration) between groups (SB vs CC, SB vs SC and CC vs SC)
Time frame: from end of surgery until 12 (noon) on POD 2 (Postoperative Day)
VAS (Visual analog scale) flexion
VAS pain score (0-100mm) during 45 degrees active knee flexion
Time frame: o Pain is recorded preoperatively before administration of medication, and postoperatively at the PACU (Postoperative Care Unit), at 8 PM on the day of surgery, at 8 AM, 12 (noon) and 8 PM on POD 1 and finally at 8 AM and 12 (noon) on POD 2.
VAS rest
VAS pain score (0-100mm) during rest
Time frame: o Pain is recorded preoperatively before administration of medication, and postoperatively at the PACU, at 8 PM on the day of surgery, at 8 AM, 12 (noon) and 8 PM on POD 1 and finally at 8 AM and 12 (noon) on POD 2.
VAS-TUG (Time-Up-and-Go-Test)
Worst VAS pain score (0-100mm) during Timed-Up-and-Go test
Time frame: 12 (noon) on POD 1 and 2
TUG-test
Timed-Up-and-Go test
Time frame: 12 (noon) on POD 1 and 2
6 minutes walk test
How many meters the patient can walk (using a high 4-wheel walker) in 6 minutes
Time frame: 12 (noon) on POD 1 and 2
MVIC (Maximum Voluntary Isometric Contraction)
Quadriceps strength assessed as maximum voluntary isometric contraction in percentage of preoperative baseline values.
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0.1ml of ropivacaine 0.2% every 8 hour in the sham catheter
Time frame: Preoperatively and at 12 (noon) on POD 1 and 2
TUG test, patient number
Number of patients able to perform the TUG test using a high 4-wheel walker
Time frame: 12 (noon) on POD 1 and 2